key: cord-0724485-q9mgjcuj
authors: von Linstow, Marie‐Louise; Kruse, Alexandra; Kirkby, Nikolai; Marie Søes, Lillian; Nygaard, Ulrikka; Poulsen, Anja
title: Saliva is inferior to nose and throat swabs for SARS‐CoV‐2 detection in children
date: 2021-08-02
journal: Acta Paediatr
DOI: 10.1111/apa.16049
sha: 372a508e9f921c54ea8a709a01140be25f8515ad
doc_id: 724485
cord_uid: q9mgjcuj

It is important to identify children and adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as they are often asymptomatic and may unintentionally spread the virus. However, information on the best sampling methods are limited. Most analyse nose and throat swabs with real-time polymerase chain reaction (RT-PCR), but these tests are uncomfortable and young children may not co-operate, increasing sub-optimal sample collection and false-negative results. Detecting SARS-CoV-2 in adult saliva, using RT-PCR1,2 has shown promise. However, young children struggle to produce saliva spontaneously and there have been conflicting results about using this method for children.3,4 In contrast, oral swabs cause minimal discomfort, do not generate aerosols, collect adequate viral material5 and can be used by parents or day care staff without personal protective equipment.

It is important to identify children and adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as they are often asymptomatic and may unintentionally spread the virus. However, information on the best sampling methods is limited.

Most sampling tests analyse nose and throat swabs with real-time polymerase chain reaction (RT-PCR), but these tests are uncomfortable, and young children may not co-operate, increasing suboptimal sample collection and false-negative results.

Detecting SARS-CoV-2 in adult saliva, using RT-PCR, 1,2 has shown promise. However, young children struggle to produce saliva spontaneously, and there have been conflicting results about using this method for children. 3, 4 In contrast, oral swabs cause minimal discomfort, do not generate aerosols, collect adequate viral material 5 and can be used by parents or day-care staff without personal protective equipment.

This prospective cohort study evaluated using saliva to detect SARS-CoV-2 in nonhospitalised children. We recruited 20 children Informed consent was obtained from the parents and adolescents.

We studied 13 boys and seven girls, with a median age of five (range 7-16 years) years. All had symptoms for at least one day, including fatigue (n = 16), cough (n = 14) and coryza, fever and reduced appetite (n=12). Diagnostic RT-PCR tests were performed 0-17 days after symptoms started.

During the first and second weeks after the PCR-RT tests, SARS-CoV-2 was detected in 29% and 11% of saliva samples, 86% and 50% of nasal swabs and 58% and 40% of throat swabs, respectively ( Table 1) 

Diagnosis of SARS-Cov-2 infection by RT-PCR using specimens other than naso-and oropharyngeal swabs: a systematic review and meta-analysis

Saliva as a diagnostic specimen for detection of SARS-CoV-2 in suspected patients: a scoping review

Saliva is not a useful diagnostic specimen in children with Coronavirus Disease

Viral RNA load in mildly symptomatic and asymptomatic children with COVID-19

Excretion patterns of human metapneumovirus and respiratory syncytial virus among young children